Comparison between tension band and cerclage with X-Plate and lag screws in treatment of comminuted patellar fractures |
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| Authors: | Depeng Meng Yichen Meng Bingyang Li Guigang Zeng Bin Zhang Chunlin Hou Haodong Lin Yueping Ouyang |
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| Affiliation: | 1. Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China;2. Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, PR China;3. Department of Orthopedics, Integrated Chinese and Western Medicine Hospital of Minhang District, Shanghai, PR China;4. Department of Orthopedics Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China;1. Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan;2. Department of Anesthesiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan;3. Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan;1. Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China;2. The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang, China;3. Department of Orthopaedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China;4. Basic Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China;5. Department of Orthopaedics, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi, China;6. Department of Orthopaedics & Traumatology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, 528401, Guangdong, China;1. Dept. of Orthop. Surg., Hokkaido Medical Center for Child Health and Rehabilitation, Japan;2. Dept. of Physical Therapy, Hokkaido Medical Center for Child Health and Rehabilitation, Japan;3. Dept. of Prosthetics and Orthotics, Hokkaido University of Science, Japan;4. Dept. of Orthop. Surg., Sapporo Child Development General Support Center, Japan;5. Dept. of Orthop. Surg., Sapporo Medical University, Japan;1. Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;2. Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA |
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| Abstract: | BackgroundComminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat comminuted patellar fractures.MethodsFrom March 2010 to August 2016, 102 cases of 34-C2 or 34-C3 comminuted patellar fractures were treated at our hospital, wherein patients received two different treatments: titanium cable tension band with cerclage method (group A) and intrafragmentary screws with X-shaped plating technique (group B). At follow-ups, articular step-off, range of motion (ROM), Lysholm scores, time of union, and complications were recorded and analyzed. Radiographic and clinical data as well as rate of complications were statistically analyzed.ResultsIn total, 87 patients were included in the final analysis (n = 47 in group A and n = 40 in group B). No significant differences were noted in terms of cost of implant, age, gender, rate of 34-C3 fractures, rate of layered inferior pole fractures, postoperative articular step-off and union time. At 2-year follow-up, average Lysholm scores, ROM and rate of complications were (89.0 ± 4.5), (122°±12°) and (27.7%) in group A and (90.2 ± 3.9), (124°±11°) and (17.5%) in group B, respectively, with no significant differences (p > 0.05). The mean time of surgery in group B was shorter than that in group A with significant difference (p < 0.05).ConclusionsTreatment using the intrafragmentary screws and plate method for amenable comminuted patellar fractures achieved similar complication rate and favorable functional outcomes at the 2-year follow-up, which was comparable to the titanium cable tension band with cerclage method. Thus, the intrafragmentary screws and plate method is effective, safe and convenient for 34-C2/C3 comminuted patellar fractures, especially appropriate for patients with layered fragments. |
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